TCT-277 Characteristics and Clinical Outcomes of DanGer Shock-Like and Non–DanGer Shock-Like Patients in AMICS Treated With Impella Support: Insights from RECOVER III and NCSI Registries
Recommended Citation
Falah B, Shah J, Moeller J, Bieniarz M, Thompson J, Hanson I, Batchelor W, Goli S, Ako J, Cohen D, Schonning M, O'Neill W, Burkhoff D. TCT-277 Characteristics and Clinical Outcomes of DanGer Shock-Like and Non–DanGer Shock-Like Patients in AMICS Treated With Impella Support: Insights from RECOVER III and NCSI Registries. J Am Coll Cardiol 2025; 86(17):B122-B123.
Document Type
Conference Proceeding
Publication Date
10-28-2025
Publication Title
J Am Coll Cardiol
Abstract
Background: The DanGer Shock trial shifted AMICS management by showing improved outcomes with early pLVAD support, though concerns about its generalizability persist. We assessed outcomes in pLVAD-supported AMICS pts stratified as DanGer Shock-like or non-DanGer Shock-like, using pooled data. Methods: DanGer Shock-like and Non-DanGer Shock-like pts were identified from the National Cardiogenic Shock Initiative (NCT03677180) and RECOVER III (NCT04136392) observational, multicenter, single-arm studies of AMICS pts revascularized with Impella. DanGer Shock-like was defined by absence of: STEMI, out-of-hospital cardiac arrest, IABP prior to Impella, use of Impella RP, and Impella use >24h from shock onset. Mortality was assessed at discharge, 30 days, and 1 year. Results: Of 804 pts in the pooled database, 539 with complete data were analyzed; 298 (55.3%) met criteria for the DanGer Shock-like group. Patient demographics were similar between groups. Non-DanGer Shock-like pts more often presented in CSWG SCAI stage E (79.3% vs. 44.6%; p<0.0001), with higher baseline lactate, more shock at admission, and greater use of inotropes/vasopressors. Among STEMI pts, door to support time was longer in the non-DanGer Shock-like group. Survival at discharge, 30-day mortality, or 1-year mortality did not differ significantly. (Figure) [Formula presented] Conclusion: Despite greater illness severity and delayed support, non-DanGer Shock-like pts had similar outcomes compared to DanGer Shock-like pts. While encouraging, whether Impella improves outcomes in non-DanGer Shock-like pts remains speculative and warrants confirmation in a randomized trial. Categories: CORONARY: Hemodynamic Support, Cardiogenic Shock and Cardiac Arrest
Volume
86
Issue
17
First Page
B122
Last Page
B123
